Make sure you learn the following OSCE topics, examinations and procedures before the end of semester 8 (and certainly before the end of semester 9!). For the last two years every single OSCE station has been a repeat and this is highly likely to be the case again for 2012.

Year

History Stations

Examination Stations

2014 MD2

1) Review of COPD

2) Syncope (DDx was seizure)

3) Claudication (DDx was superficial femoral thrombosis)

Neck lump

Difficulty walking (hip + LL neuro, others did back) too much variability so this was cut.

2013 MD2

Acute headache (SAH)

Iron deficiency anaemia

Weight loss in 26yr (T1D)

Acute abdomen (cholecystitis)

Respiratory exam (COPD)

2012   Sem 9

Jaundice in returned traveller

Palpitations (AF)

Respiratory exam (COPD patient)

Knee exam (medial collateral ligament injury)

Procedure: venepuncture & interpreting FBE

2011   Sem 8

Iron deficiency anaemia

Thunderclap headache

Acute monoarthritis (septic joint vs gout)

Obstructive sleep apnoea

UL neuro exam (ulnar nerve compression)

Acute abdo (cholecystitis)

Thyroid exam

Cardiovascular exam (mitral regurgitation)

2011   Sem 9

Jaundice in returned traveller (must take sexual Hx)

Vascular Hx/claudication

Sudden collapse (Vent tachy)

- Hx from patient themself

Lumbar back examination

Procedure: venepuncture & interpreting FBE results

2010   Sem 8

Dysphagia

Cough (in a pt with COPD)

Type I diabetes (recurrent hypos)

Anaemia

Cardiovascular exam (murmur: either AS or MR)

UL neuro exam (ulnar nerve compression at elbow)

Breast exam (real patient)

Shoulder exam

2010   Sem 9

Acute abdo (cholecystitis: DDX perforated peptic ulcer)

Calf pain (DVT)

Cardiac (murmur: AS or MR)

Lumbar back exam

Procedure: urinary catheterisation

2009   Sem  8

PR bleeding

Lymphadenopathy

Acute monoarthritis (knee pain gout)

Palpitations (+ECG; AF)

Acute abdomen

UL neuro (ulnar nerve palsy)

Thyroid

Respiratory (COPD)

2009

Sem 9

Dizziness

Most likely diagnosis (BPPV)

Findings on physical examination (nystagmus, Hallpike positive)

Describe Hallpike manoeuvre

Back pain

Most likely pathology causing pain (mets; but no urinary symptoms)

2 features of pain suggestive of malignancy (night pain, quality)

Plain x-ray and CT of lumbar spine with lytic lesion

Diabetes complications exam (incl. BP)

Ask for weight

Fundoscopy (3 findings: microaneurysms, block haemorrhages, cotton-wool spots, neovascularisation)

Urinalysis (microalbuminuria)

Procedure: suturing

Selection of suture material (3-0 non-absorbable)

Name 2 situations where you would not suture the wound (foreign body, active infection)

Name 2 factors that can impair wound healing (smoking, steroids, hypoxia, infection, diabetes, etc)

2008

Sem 8

Type 1 diabetic having hypos

**

PR bleeding

Most important differential (colorectal cancer; half points for saying ‘bowel cancer’)

Most important investigation (c’scope)

Generalised lymphadenopathy (sexual history)

2 differential diagnoses (haem malignancy, EBV)

Interpret EBV serology

Shoulder exam

Cardiac exam

Lower limb neurological exam (MS)

Present findings, UMN vs LMN and why

Differentials

1 investigation (MRI)

Breast exam (real patient)

Describe a mammogram with a lesion

Describe appropriate management (triple investigation incl. tissue diagnosis)

Sem 9

Sudden collapse, history from partner

Most likely diagnosis (arrhythmia)

Ask for ECG (VT)

2 further investigations (cardiac enzymes, U&E)

Rheumatoid arthritis follow-up visit, on MTX

2 lab tests for acute RA

2 lab tests for MTX SE

Acute abdomen with Murphy’s sign

Ask for observations

Present at the end

4 initial management steps (IV fluid, analgesia, antibiotics, NBM)

Diabetes complications

Ask for weight

Fundoscopy (3 findings: microaneurysms, block haemorrhages, cotton-wool spots, neovascularisation)

Urinalysis (microalbuminuria)

2007

Sem 8

Back pain with vague prostate symptoms

Most likely pathology causing pain (mets)

2 features of pain suggestive of malignancy (night pain, quality)

CT of lumbar spine with lytic lesion

Cough with pneumonia

2 differentials

Physical signs to confirm pneumonia

3 common organisms (Strep, Mycoplasma, Haemophilus, Klebsiella)

Asymptomatic iron deficiency anaemia

Likely diagnosis (upper/lower GI bleed, malabsorption)

2 investigations (g’scope, c’scope)

Thunderclap headache

2 differentials (SAH, meningitis)

One investigation (CT brain)

Describe findings of CT and LP (xanthochromia vs traumatic tap)

Thyroid exam

Present findings (multinodular goitre)

Interpret TFT’s, describe scan (toxic MNG)

2 types of drugs used in hyperthyroid (carbimazole, b-blockers)

2 definitive treatments (thyroidectomy, radioactive iodine ablation)

Lumbar back exam

Clinical test for lumbar flexion (Schober’s)

Where would you look for sensory change (S1)

What reflex affected (ankle)

MRI – level of prolapse? (L5/S1)

Signs of chronic liver disease

Name 2 findings (ascites, hepatosplenomegaly, spider naevi, etc)

2 causes of decompensation (GI bleed, constipation, infection, electrolyte imbalance, hepatoma)

Blood tests to order

Visual assessment (acuity and fields)

Describe the deficit (hemianopia with macular sparing)

What investigation? (MRI)

Which lobe on the MRI is affected? (occipital)

Sem 9

Jaundice in returned traveller

Differentials (STI, viral hepatitis)

Interpret hepatitis serology

Exacerbation of SOBOE (AF)

Differentials (ie: causes of acute HF exacerbations)

Further investigations (CXR, ECG, echo)

ECG interpretation

Lower limb neurological exam (MS)

Present findings, UMN vs LMN and why

Differentials

1 investigation (MRI)

Procedure: urinary catheter

Name 2 indications for catheter (acute retention, fluid balance monitoring)

2006

Sem 8

Back pain (metastatic prostate ca)

Differentials (OA, mets)

Interpret lateral spine XR (lytic vs sclerotic)

Further investigations (CT, MRI)

COPD

Interpret spirometry

Management of poorly controlled COPD

Cholecystitis

Differential diagnosis

Features you would expect to find on US (stones, gallbladder wall thickening, pericholecystic oedema)

Migraine exacerbation (identification of triggers)

Suggest preventer medications

Diabetes complications (repeated in 2008 and 2009)

Shoulder exam

Diagnosis (supraspinatus tendonitis)

Name 4 structures other than shoulder where pain could be referred from

Abdominal exam (appendicitis)

Most likely diagnosis and why

Immediate management

Breast exam (real patient)

Describe a mammogram with a lesion

Describe appropriate management (triple investigation incl. tissue diagnosis)

Sem 9

Dysphagia

Diabetes management

Changing insulin regime

RA examination of the hand

Procedure: IV cannulation

2005

Sem 8

Haemoptysis (lung ca with CXR)

RA, and related medications

PR bleeding

Epilepsy and driving

Thyroid exam

Cardiac exam (MR or AS)

Abdominal exam (chronic liver disease)

Procedure: venepuncture

Sem 9

Returned traveller (Hep A serology)

Vascular history/claudication

Respiratory exam

Cranial nerves (visual loss and neglect, SAH on CT)

Procedure: airway management

2004

Sem 8

Asthma

PR bleeding

Headache

Back exam

Procedure: suturing

2004

Sem 9

Loss of weight (hyperthyroidism)

Epilepsy & driving

Shoulder exam

Abdo exam

Asthma prac – how to use inhaler

2003

Sem 8

Acute cholecystitis

Causes of anaemia

Eye exam

IV cannulation

1) Mr Fox is a 68 year old man who has had trouble swallowing recently. Take a history etc. Examiner then shows you an endoscopy picture. It shows oesophageal carcinoma. Asked for diagnosis, appropriate tests.

2) Some lady presents to emergency department suffering 18 hours of abdominal pain. Perform an appropriate examination and then present the patient to the examiner. RUQ pain only, Chart shows high temp, high HR. Asked for diagnosis, 4 immediate management steps.

3) Old lady who won't stop talking about random unrelated shit has had a "funny turn" today. Interview her. She has had a minor heart attack recently. Asked for most likely cause. Shown an ECG in questioning which shows VT.

4) A man has been noticing right hand weakness and numbness. Perform an upper limb neuro exam, including sensation. Likely diagnosis etc.

Yellow = repeat station.